Impacts on anxiety symptoms and alcohol consumption among people with disabilities and family caregivers in Latin America and the Caribbean during the first wave of the COVID-19 pandemic.

OBJECTIVES: The aim of this study was to analyse associations between the COVID-19 pandemic, alcohol consumption and anxiety symptoms among people with self-reported disabilities and family caregivers in Latin America and the Caribbean. STUDY DESIGN: Cross-sectional study with secondary data analysis of the 'Alcohol Use during the COVID-19 pandemic in Latin America and the Caribbean', a Web-based cross-sectional survey conducted by the Pan American Health Organisation between March and June 2020. METHODS: Descriptive analyses were conducted on the individual, social environment characteristics, COVID-19 infection, quarantine compliance, anxiety symptoms (measured by Generalized Anxiety Disorder Scale [GAD-7]) and change in frequency of heavy episodic drinking during the pandemic. Multinomial logistic regression was used to analyse associations among individuals with self-reported disabilities with anxiety symptoms and change in frequency of heavy episodic drinking during the pandemic. RESULTS: Family caregivers were more compliant with COVID-19 restrictive measures than individuals with and without disabilities. The majority of participants with disabilities did not change their drinking patterns during the pandemic (64.3%); however, 28.1% reported increased consumption. People with disabilities were 2.17 times more likely to have severe anxiety symptoms than no anxiety symptoms between March and June 2020 in Latin America and the Caribbean. CONCLUSIONS: This study observed a higher prevalence of the maintenance of heavy episodic drinking behaviour during the early phase of the pandemic in people with disabilities and family caregivers than in people without self-reported disabilities in Latin America and the Caribbean. People with disabilities showed more severe anxiety symptoms than those without disabilities, highlighting the need to develop inclusive health and quality-of-life policies to mitigate the effects of the pandemic in this vulnerable population.

Point defects and the blue emission in fired quartz at high doses: a comparative luminescence and EPR study.

The dose response of the 375 degrees C. 470 nm TL peak in fired quartz is studied by using thermoluminescence emission spectra and monochromatic glow curves. The blue emission displays a significant sensitivity increase for doses in excess of 1000 Gy, subsequent saturation at 16 kGy and a pre-dose effect over the entire dose range. Comparison with the growth of the known electron paramagnetic resonance (EPR) centres and radioluminescence emission spectra indicates that the [AlO4] centre is the recombination site for the blue emission, whereas the electron trap remains unknown. The sensitivity change seems to be linked to the dose-induced reduction of the [GeO4/Li] centre. Possible mechanisms for the observed dose response are discussed.

Comparative morphology and paleobiology of Middle Pleistocene human remains from the Bau de l'Aubesier, Vaucluse, France.

The discovery of later Middle Pleistocene human remains from the Bau de l'Aubesier, France reinforces an evolutionary model of the gradual accumulation of Neandertal-derived facial and dental features during the Middle Pleistocene of the northwestern Old World. The pronounced maxillary incisor beveling of Aubesier 4 helps to extend the antiquity of nondietary use of the anterior dentition. The interproximal "toothpick" groove on the Aubesier 10 molar increases the sample for these lesions. The pathological loss of the mandibular dentition of Aubesier 11 indicates advanced antemortem masticatory impairment, at a level previously undocumented before the Late Pleistocene. These remains support a view of later Middle Pleistocene humans able to support debilitated individuals despite the considerable use of their bodies to accomplish routine activities.

Multiple sialoliths and a sialolith of unusual size in the submandibular duct: a case report.

A 49-year-old man with multiple sialoliths in the submandibular duct is described. One of the sialoliths was of remarkable size. This report is of interest because of the unusual size and weight of this sialolith and because of the patient's symptoms, which were relatively mild and of short duration.

Fatalities assessed by the Orange County child death review team, 1989 to 1991.

Interagency child death review teams have emerged in response to the increasing awareness of severe violence perpetrated against children in the United States. Child death review involves a systematic, multidisciplinary, and multiagency process to coordinate data and resources from the coroner, law enforcement, the courts, child protective services, and health care providers. The Orange County, CA team reviews all coroner's cases (unattended death or questionable cause of death) for children 12 years old and younger. This paper describes the interagency review in Orange County and provides data on the demographics of cases reviewed by the team (N = 637) compared to unreviewed deaths (N = 1,463) for the period 1989 to 1991. Trends were analyzed to assess differences in: (1) age distribution; (2) gender; (3) ethnicity; (4) cause of death (non-SIDS natural; non-natural including traffic deaths, SIDS, other injuries; homicide; and undetermined); and (5) cause of death by age, gender, and ethnicity. Implications of the data for other jurisdictions with child death review teams are discussed.

Lead poisoning among low-income children in Orange County, California. A need for regionally differentiated policy.

OBJECTIVE: To estimate the prevalence of elevated lead levels among children in Orange County, California, and to evaluate the appropriateness of a universal pediatric blood lead screening policy in this community. DESIGN: Venous blood lead testing was conducted and results were analyzed according to seven blood lead strata ranging from less than 0.50 mumol/L (10 micrograms/dL) to 3.35 mumol/L (70 micrograms/dL) or higher. A cost analysis of the lead-testing program in Orange County was conducted. SETTING: Children meeting poverty eligibility criteria and attending the Child Health and Disability Prevention Program, the state's implementation of the federal Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services program. PARTICIPANTS: A total of 5115 Orange County children between 12 and 72 months of age using EPSDT services from March through December 1992. MAIN OUTCOME MEASURES: Blood lead levels and associated costs of the testing program stratified by level of blood lead elevation. RESULTS: Blood lead levels of 0.50 mumol/L (10 micrograms/dL) or higher were found in 371 children (7.25%; 95% confidence interval, 6.66% to 7.85%), but only six children (0.12%; 95% confidence interval, 0.04% to 0.20%) had elevations greater than 1.20 mumol/L (25 micrograms/dL). Five children (83.3%) had histories of lead consumption unrelated to ingestion of lead-containing paint but related to the use of lead-containing folk remedies and cooking utensils. Costs for detection of children with blood levels elevated to 0.50 mumol/L (10 micrograms/dL) or higher was $310 per child and for levels of 1.20 mumol/L (25 micrograms/dL) or higher was $19,139 per child. CONCLUSIONS: These data suggest that lead poisoning is not a major public health problem among Orange County children and detection of infrequent cases would involve a high cost per child. In jurisdictions with newer housing, initial screening for a history of possible lead exposure alone may offer reasonable efficacy that is cost-effective. The scope of lead-testing programs should be determined according to local needs and conditions.

Ambulatory adult tonsillectomy.

The purpose of this paper is to demonstrate whether it is reasonable to perform tonsillectomies on adults on an ambulatory basis. The method was a retrospective hospital chart review of all 383 patients operated on by one surgeon over a sequential 10-year period. The findings were a low admission rate of 7.05%, no serious complications, and excellent acceptance by patients, surgeon, and other involved health care providers. The conclusion is that ambulatory adult tonsillectomy is safe, cost-effective, and convenient.

Epistaxis.

Epistaxis is discussed. Three unusual cases are reported. The first was a patient with a basal skull fracture due to a motor vehicle accident. He developed a carotid-cavernous fistula causing epistaxis severe enough to cause a cardiac arrest on one of his bouts of severe bleeding. The second was an unusual complication of a rhinoplasty due to damage to the anterior ethmoidal artery from the medial osteotomy. The third was due to psychopathology causing an adult female to traumatize her nose as an attention-getting or defence mechanism causing epistaxis with anemia requiring bi-annual blood transfusions of more than 175 units of blood over a 20 year period. Management is described.

Mycotic infections of the head and neck.

Mycotic infections of the head and neck may mimic bacterial infections. The treatment is different, however, and inappropriate treatment will worsen the prognosis markedly. The diagnosis is straightforward, provided a high index of suspicion is maintained. Most of these infections respond well to the appropriate treatment.

Sports injuries of the ear.

The author describes common sports injuries involving the ear. Such injuries include hematoma, lacerations, foreign bodies (tattoo), and thermal injuries. Ear canal injuries include swimmer's ear and penetrating injuries. Tympanum injuries include tympanic membrane perforations, ossicular discontinuity, eustachian tube dysfunction, temporal bone fractures and traumatic facial nerve palsy. Inner ear injuries include traumatic sensorineural deafness. The author emphasizes the management of these injuries.

Fission track ages and ages of deposition of deep-sea microtektites.

The Australasian and Ivory Coast deep-sea microtektites have fission track ages of 0.71 and 1.09 million years, respectively. These ages are in good agreement with the ages of deposition of the microtektites determined from paleomagnetic data. Both the fission track ages and ages of deposition of the microtektites agree with the potassium/ argon and fission track ages of tektites from the respective tektite strewn fields.